| Healtheast Outer Banks Medical Center Llc | |
|
40894 Hwy 12 Avon NC 27915 | |
| (252) 995-3073 | |
| Not Available |
| Full Name | Healtheast Outer Banks Medical Center Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 40894 Hwy 12, Avon, North Carolina |
| Authorized Official Name and Position | Lynn T. Lanier (VP OF FINANCE FOR EAST CAROLINA HEA) |
| Authorized Official Contact | 2528477479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healtheast Outer Banks Medical Center Llc 40894 Hwy 12 Avon NC 27915 Ph: (252) 995-3073 | Healtheast Outer Banks Medical Center Llc 40894 Hwy 12 Avon NC 27915 Ph: (252) 995-3073 |
| NPI Number | 1174585012 |
|---|---|
| Provider Enumeration Date | 04/05/2006 |
| Last Update Date | 06/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174585012 | NPI | - | NPPES |
| 0290R | Other | NC | BCBS PROVIDER # |
| 790290R | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |